BiMax + Implants (Looking for Advice)

[Vercel]

Hi, i have my first appointment with my Oral and maxillofacial Surgeon in two weeks and would appreciate any Input / suggestions if someone has knowledge.

I'm getting BiMax (BSSO & Le-Fort I (3 Piece Y Cut (Kühle said we need a 3-Piece Le-Fort I on the phone after seeing old X-Rays, i was already at the same Clinic as a child, but my Insurance didn't approve Surgery back then for some reason))) together with a Genioplasty for fucked bite / health reasons (anterior open bite, small overbite and asymmetry and alsp small airway? i dont have a cbct or ct with airway analysis yet, but the airway looks like less than 10mm horizontally in some areas and i do snort sometimes when sleeping on my back, so probably UARs too), but i obviously mostly care about the aesthetic outcome.

The Surgery is covered by insurance now luckily.

My Surgeon (Dr. med. Dr. med. dent. Reinald Kühle) is definitely *aware*, he does custom? (i think they are all custom titanium) facial implants (infraorbital, malar and Jaw angle Implants for sure) together with regular BiMax for some cases.

I saw a post of a guy who got operated by the same surgeon and got Malar and Jaw Angle Implants for free (covered by insurance) together with his BiMax, so if im lucky i can get implants covered by Insurance together with the BiMax.

I asked him on the phone months ago (im not 100% sure if i talked to him or someone else) and asked if Infraorbital Rim Implants are possible and he said "yes, but they are not free".

This guy definitely got Jaw Angle and Malar Implants for free covered by Insurance, i don't know why Infras would cost something while Jaw Angle and Malars are free, makes no sense..

I got a blackpilled Bimax including malar + jaw angle implants for free, Germancels GTFIH

Results first (tried to match the angle): Side: Upper lip, lower jaw and cheeks are still very swollen and jaw implants aren't in yet (surgeon said he adds them after a year so he can adjust the aesthetics better in case the bone doesn't fuse properly). Currently 3 months post-OP...

looksmax.org

But if I would benefit from some Implants, and they aren't too expensive I would pay for them myself.

I was also offered Chin Wing on the phone from the surgeon (Kühle?), he said we can make my jaw more manly, he's definitely blackpilled and most likely deals with people who informed themselves on looksmax forums regularly

I don't know if Chin Wing is good for my case tho (i would have to get two surgerys because i doubt anyone combines BSSO and Chin wing, I don't even think it's possible (maybe if they make the vertical cut for the BSSO a little higher?) but even then probably too risky

And i read that Chin Wing worsens the jaw angle? Mine is already high i think (high gonion angle)

So BSSO + Jaw Angle Implants is probably better

I have like no Chin so a big Genioplasty is definitely happening i think

I attached some photos and a Video, would appreciate it if anyone can tell me if i would profit from certain implants (jaw angle, malar, infraorbitals)?

 

[lurking truecel]

Do the surgeon do jaw widening with bimax ? Do you have any TMJ issues as of now ?

 

[lurking truecel]

Your jaw angle is 126 which isnt to bad but you should not do chin wing

 

[Vercel]

Do the surgeon do jaw widening with bimax ? Do you have any TMJ issues as of now ?

Hey, you mean Jaw Widening through Condylar torquing?

From my understanding it always happens to *some* extend during BSSO when not using Custom Guides & Plates for the BSSO, not sure if he would intentionally torque it outwards - i have to ask.

He only uses Custom Guides & Plates for the Le-Fort I, but not for the BSSO - so it will happen to some extend.

I don't have TMJ (Doctor checked), i only have Clicking / Popping when opening my Mouth.

When i Jutt my lower Jaw forward to intentionally create an Underbite the Clicking / Popping is gone when i open my mouth - so i hope it will be gone after the Surgery.

---

Thanks for answering

 

[NZb6Air]

infras for sure but whether zygos or not (which would allow jaw angles) can't tell cause u're fat af

 

[Vercel]

infras for sure but whether zygos or not (which would allow jaw angles) can't tell cause u're fat af

Hi, thanks for answering.

Yes, i gained a lot of weight in the Video compared to the 1st picture, i don't have a Photo or Video of me from the front when i was lean unfortunately.

Zygo / Malar / Cheek implants generally refer to the same area, right?

Can you explain what you mean by "(which would allow jaw angles)"

Do they depend on each other / is it generally recommended to combine them?

 

[NZb6Air]

Hi, thanks for answering.

Yes, i gained a lot of weight in the Video compared to the 1st picture, i don't have a Photo or Video of me from the front when i was lean unfortunately.

Zygo / Malar / Cheek implants generally refer to the same area, right?

Can you explain what you mean by "(which would allow jaw angles)"

Do they depend on each other / is it generally recommended to combine them?

bizygo width should be bigger than bigonial width

 

[Vercel]

bizygo width should be bigger than bigonial width

Oh, i thought it should ideally be close to 1:1 like in this Picture.

I'm obviously lacking bi-gonial width, that's why the other guy asked if my Surgeon can widen it with Condylar torquing.

 

[NZb6Air]

Oh, i thought it should ideally be close to 1:1 like in this Picture.

I'm obviously lacking bi-gonial width, that's why the other guy asked if my Surgeon can widen it with Condylar torquing.

that's not where his bitemporal and bigonial end at, it's skeletal

u prolly did this mistake too @ronald_2

 

[ronald_2]

that's not where his bitemporal and bigonial end at, it's skeletal
View attachment 3286877

u prolly did this mistake too @ronald_2

That explains why my measurements for both were way above the mean in the chart you posted.

Still I have a too wide jaw at 120mm, the mean being 105. I'm fucked.

 

[Vercel]

that's not where his bitemporal and bigonial end at, it's skeletal
View attachment 3286877

u prolly did this mistake too @ronald_2

Thanks for explaining, yeah 1:1 skeletal would look ridiculous.

Most accurately measured by taking a CBCT or CT then?, i can actually measure myself once i have my Scans since i have access to KLS Martin IPS Case Designer (which is also the same Software my Surgeon / the Hospital uses).

Bizygomatic to Bigonial width ratio of 140 mm to 105 mm from your list translates to a ratio of 1.33:1.

 

[ronald_2]

Thanks for explaining, yeah 1:1 skeletal would look ridiculous.

Most accurately measured by taking a CBCT or CT then?, i can actually measure myself once i have my Scans since i have access to KLS Martin IPS Case Designer (which is also the same Software my Surgeon / the Hospital uses).

Bizygomatic to Bigonial width ratio of 140 mm to 105 mm from your list translates to a ratio of 1.33:1.

Hi. One question. Do you feel your face width is around average or above?

 

[Vercel]

Hi. One question. Do you feel your face width is around average or above?

Hey, if you mean generally then my bi-zygomatic and bi-gonial (or entire face) width (skeletal) is probably in the lower end / average range.